BALTIMORE — President Trump and most Republicans are happy to run in 2020 on the economy, a hard-line immigration policy and a steady diet of attacks on left-wing Democrats.
Meeting for their annual legislative retreat here nearly nine months into the minority, top GOP officials couldn’t help but raise matters such as health care and skyrocketing budget deficits that bedeviled the party before last year’s House Democratic midterm sweep.
If Trump is reelected, the GOP recaptures the House and holds the Senate, the president and Republicans said they would try again to scrap the 2010 law that has provided coverage for tens of millions of Americans and ensured health care for those with preexisting medical conditions.
The American people “want us to focus on lowering costs, giving them more choice and protecting people with preexisting conditions,” Minority Whip Steve Scalise (R-La.) said Friday, rekindling talk of an Affordable Care Act replacement. “That’s what we stand for. That’s what we want to implement when we get the new majority next year, which we will.”
But nine years after Obamacare, the GOP has been unable to come up with an alternative that fulfills those promises. The Trump administration, meanwhile, is pressing federal courts to declare the law unconstitutional, with a ruling expected this fall.
Trump and Republicans had full control of the White House and Congress for two years, yet never made the deep spending cuts to rein in deficits and passed a tax cut that is projected to add $1.9 trillion to the deficit over 10 years.
On Thursday, the Treasury Department said the federal deficit topped $200 billion in August, bringing the total deficit for the year to more than $1 trillion.
“The first thing we would do is make sure our debt is taken care of,” House Minority Leader Kevin McCarthy (R-Calif.) told reporters.
But while acknowledging the need to appeal to voters concerned about those issues, GOP leaders stopped short of fully embracing any particular course correction — with little evidence, for instance, of any policy shift from the health-care approach that drove successful Democratic campaigns in 2018 or any new strategy for overhauling popular entitlement programs such as Medicare and Social Security. Those programs are the main drivers of long-term budget deficits.
The more dominant theme of GOP messaging during the retreat had to do with the other party — with leader after leader, starting with Trump on Thursday night and continuing with Vice President Pence on Friday, focused on the ascendant left-wing agenda in the Democratic presidential race and, to a lesser extent, in the House.
“The choice in this election, I think, has never been clearer and the stakes have never been higher,” said Pence, delivering a luncheon address where he called Democrats the party of “left-wing liberals who want higher taxes, open borders, free health care for illegal immigrants, the Green New Deal, late-term abortion and [who] even defend infanticide.”
Yet amid the attacks on purported Democratic overreach and even as they touted wins in a pair of North Carolina House special elections this week, Republicans subtly acknowledged they have work to do on their policy agenda going into 2020, even if they are not entirely sure how to go about it.
The top Republicans on the House committees dealing with health-care policy each lambasted Democratic proposals floated in the presidential campaign, from single-payer Medicare-for-all plans to the expansion of the Affordable Care Act to include government-run options.
“But we also recognize people are frustrated with their health care,” said Rep. Kevin Brady (Tex.), ranking Republican of the House Ways and Means Committee. “There is a lot more work to be done. Insurance is complicated. Costs are high. Medicines go up and spike after being in place for decades. We’re going to work on improving the system we have today — keeping what’s working, fixing what’s broken — but not throwing all that away and starting over.”
The health-care debate might not wait until voters go to the polls next November: More than a dozen GOP-controlled states are currently suing to overturn the ACA with the Trump administration’s backing, and a federal appeals court could rule within weeks, putting the issue in the hands of a Supreme Court with a solid conservative majority.
Democrats carpet-bombed Republicans with health-care attack ads ahead of the midterms that highlighted the 2017 GOP push to repeal the ACA — an effort that fell one vote short in the Senate. The Democratic candidate in one of Tuesday’s special elections, Dan McCready, focused heavily on the issue in his race against GOP Rep.-elect Dan Bishop. Bishop ultimately won by two points in a district Trump won by 12 points in 2016.
The most potent Democratic attacks have surrounded protections for people with preexisting conditions, and the issue has been vexing Republicans for years. At a party retreat in 2017, days after Trump was inaugurated, GOP lawmakers openly fretted about having to dismantle the ACA in a private meeting that was secretly recorded and shared with reporters.
A similar health-care-focused session was held at this year’s retreat, but the leaders of the discussion said it had more to do with solutions to relatively small-bore problems — like surprise overbilling and generic drug marketing — than forging a new policy approach to the system.
A senior Republican aide who spoke on the condition of anonymity to describe the private meeting, said lawmakers “want to move away from talking about repeal-and-replace” and move toward contrasting “personalized” GOP health plans with “one-size-fits-all” Democratic proposals.
If anything, that is an evolution from 2017, when Brady discussed creating a health-care “backpack” that could be personalized and toted from job to job. The problem for Republicans was that their policies could not maintain key protections in the ACA, opening the door for Democratic attacks.
“Our legislation always protected people with preexisting conditions, hard stop, period, it always did,” said Rep. Greg Walden (Ore.), ranking Republican of the House Energy and Commerce Committee. “The messaging got spun out of control.”
Brady and Walden have introduced legislation intended to enshrine those protections in case the states’ lawsuit succeeds in undermining the ACA. But Democrats and independent health-care analysts say it would leave gaping holes for consumers — including the erosion of ACA standards that require a full range of health conditions to be covered as well as the likely return of annual or lifetime benefit caps.
Regarding the federal budget, Pence, McCarthy and other Republicans rapped Democrats for failing to pass a budget blueprint this year due to internal splits in their party over defense spending and other issues. But Republicans had similar issues passing budgets in their majority, and under Trump, spending ticked up considerably as the GOP, intent on hiking defense spending, cut deals with Democrats that also involved increases in domestic programs.
McCarthy, detailing his views on the national debt Friday, did not mention the 2017 Republican tax cuts. He instead pointed to Republican efforts during the Obama administration to rein in discretionary spending. That showdown produced a 10-year framework that is set to expire in 2021, setting the stage for a potential explosion in spending.
“If we are given the majority and the opportunity one more time, our promise will be: We will not allow the Democrats to stop us again,” McCarthy said. “We came one vote short in the Senate from entitlement reform. We will have the ability, with a Republican Senate and with President Trump, to change it once for all and make America strong.”
Trump, meanwhile, had a different message. He made no mention of the debt or deficit in his remarks to lawmakers Thursday but did say he was looking at another tax cut, aimed at “the middle-income people.”
“That is going to be very, very inspirational,” he said. “It’s going to be something that I think it’s what everyone is really looking for.” He did not mention how, or whether, it might be paid for.
Rachael Bade and Paul Kane contributed to this report.